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Using Real-Time Analytics to Improve
Patient Clinical Outcomes
Session #174, February 13, 2019
Robert Altemose MSN RN, Corporate Analytics Director Clinical Operations Analytics, AdventHealth
Judi Reed MSN MSHI CPHIMS, Sr Manager Clinical Operations Analytics and User Experience, AdventHealth
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Robert Altemose MSN RN
Has no real or apparent conflicts of interest to report.
Judi Reed MSN MSHI CPHIMS.
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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• Learning Objectives
• Back to Basics
• Poll on handwriting
• Past Techniques
• Listening to the customer
• Identify how to successfully deploy and integrate real-time
analytics
• Share the positive and negative experiences associated with
developing and deploying real time data visualization tools
Agenda
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• Explain back to basics – Reasons to Build and Incorporate Real
Time Analytics, and Who is the Target Audience
• Evaluate when to listen to customers and when to think differently
• Identify how to successfully deploy and integrate real-time
analytics
• Share the positive and negative experiences associated with
developing and deploying real time data visualization tools
Learning Objectives
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The problem
• According to the Centers for Disease
Control, approximately one out of every
twenty-five patients develop a healthcare
related infection (U.S. Centers for Disease
Control and Prevention, 2018)
• Patients who acquire infections from
surgery spend, on average, an additional
6.5 days in the hospital, are five times
more likely to be readmitted after discharge
and twice as likely to die (PatientCareLink,
2018)
Back to the Basics
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“The main challenge is to ensure implementation of and
compliance
with the evidence-based recommendations in daily nursing
practice” (Humphrey,2015).
CLABSI Prevention
Humphrey, J. S. (2015). Original Article: Improving Registered Nurses' Knowledge of Evidence-Based Practice Guidelines to Decrease the
Incidence of Central Line-Associated Bloodstream Infections: An Educational Intervention. Journal Of The Association For Vascular
Access, 20143-149. doi:10.1016/j.java.2015.05.003
Challeng
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• Nurses have ability to significantly reduce CLABSI rates
– Aseptic Placement
– Assess for need
– Proper maintenance
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What is the date on this dressing?
a.) 06/13
b.) 06/15
c.) 06/16
d.) 06/18
Polling Question #1
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06/15
Correct Answer
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What is the date on this dressing?
Polling Question #2
a.) 12/07
b.) 12/17
c.) 12/09
d.) 12/19
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12/17
Correct Answer
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What is the date on this dressing?
Polling Question #3
a.) 11/24
b.) 11/27
c.) 11/29
d.) I don’t want to know it is wet and nasty
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11/24
Or
Wet and nasty would work too
Correct Answer
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CLABSI Reduction Techniques
• Trending reports
• Electronic Documentation
• Education
• Standardizing Shift Report
• Patient care dashboard
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I have too
much
information to
remember for
handoff
I read the date
wrong and
missed the
change
I can’t
remember
everything
Question to the nurses:
Why can’t we decrease our CLABSI rates?
Listen to the Customer
I follow
evidence based
practice, I just
missed it this
time
Can you
read the
dressing
change
I did not know
the dressing
change was
due
It’s too late
it already
happened
I saw the
charts and
thought we
were doing
good
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• Care Quality Control
• Process Control
Goals
ACTION! ……Not Reaction.
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• Customer(s)
• Frequency of Updates
• Scalability
• Intuitive
• No Data Stored
• Built to Follow Process
Design Decisions
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Build Process
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Build Process
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Build Process
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Build Process
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Overdue CVCs
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CVCs Summary All
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CVCs Detail All
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Involuntary Hold (Baker Act)
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Process Tracking
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Charge Summary
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Metrics Definitions
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Impact
CVC Dressing Changes Go-Live
CVC Dressing Changes 1 Year Later
44 of 381 overdue
14 of 425 overdue
Impact to CLABSI-SIR
Region 1 – 12 months
62.5% Decrease
Region 2 – 6 months
29.6% Decrease
Region 3 – 5 months
51.6% Decrease
3.3%
11.5%
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Recent HIMSS Analytics EMRAM Stage 7 Attestation
• Quality Improvement and Increased Productivity
– Flu and Pneumonia Vaccines
• 2016 Flu season = 93.28%
• 2017 Flu season = 98.60%
– CMS Star rating increased from 3-4
AdventHealth’s 14
th
and 15
th
Stage 7 Hospitals
More Impact
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Remember
ACTION! ……Not Reaction.
